Procedural Dermatology Research Articles

Analysis of Pediatric Procedural Dermatology at a Tertiary Care Referral Hospital in Eastern India

Background: Pediatric procedural dermatology is a broad and emerging aspect in the field of dermatology. Pediatric procedures require great expertise, skill, empathy, and confidence on the part of the treating physician. The challenging factors such as parental anxiety and doubts, the child’s cooperation, and the risks versus benefits are further contributory. Objective: The objective of the study was to summarize the risks of intra- and postoperative complications/side effects during diagnostic and therapeutic procedure in the pediatric population. Materials and Methods: We conducted a retrospective study in our hospital. Patients were taken between ages 0 and 18 years who had attended the dermatology outpatient department from January 2019 to March 2022. Results: In a total of 527 outpatient department patients, 267 (50.66%) were males and 260 (49.33%) were females (male:female ratio 1.02:1). Out of diagnostic procedures, the most commonly performed procedures were punch biopsy (14.61%), followed by autologous serum skin test (11.81%) and slit-skin smear (1.90%). Out of 15 therapeutic procedures, intralesional steroids (21.34%) were the most frequently performed therapeutic procedure, followed by radiofrequency cauterization (16.51%), autologous skin therapy (6.98%), cryotherapy (8.76%), nail surgery (2.79%), chemical peeling (2.79%), comedone extraction (2.66%), chemical cauterization (2.54%), neodymium-doped yttrium aluminum garnet laser (2.16%), platelet-rich plasma therapy (1.39%), diode laser (1.27%), measles, mumps, and rubella vaccine injection (0.89%), fractional carbon dioxide laser (0.63%), suction blister epidermal grafting (0.63%), and platelet-rich fibrin therapy (0.25%). Conclusions: This study provided comprehensive data on the various dermatological procedures done for pediatric cases in a tertiary care teaching hospital. Both diagnostic and therapeutic procedures caused mild and transient side effects such as pain, edema, erythema, burning sensations, and irritation that did not affect the patient’s lifestyle.

JAAD Game Changer: “Medical and aesthetic procedural dermatology recommendations for transgender patients undergoing transition”

JAAD Game Changer: “Medical and aesthetic procedural dermatology recommendations for transgender patients undergoing transition”

42213 Reducing Patient Anxiety in Procedural Dermatology: A Systematic Review

42213 Reducing Patient Anxiety in Procedural Dermatology: A Systematic Review

DE05 Designing and implementing dermatology procedural video education for trainees

Abstract Surgical exposure can be varied during specialty training in dermatology. During the COVID-19 pandemic, this was compounded by the reduction in face-to-face teaching, adding a further barrier for trainees trying to access practical skills training. We sought to enable uniform, accessible and inclusive teaching of common biopsy techniques to improve the confidence and proficiency of dermatology trainees in performing these procedures, through a virtual self-directed format. We produced a series of concise educational videos detailing the biopsy consent process and instructional videos on techniques for punch biopsy, shave biopsy, incisional biopsy and simple excisions. Each video was ∼10 min in length with demonstration of the technique on porcine skin in real-time and step-by-step narration. The videos were developed according to up-to-date recommendations of best practice, including those from the British Society of Dermatological Surgery. We used multidisciplinary expert input from Mohs surgeons, specialist nurse practitioners, dermatopathologists, clinicians with expertise in medical education, learning innovation advisors and media experts. We highlighted important learning points for trainees during the videos such as common biopsy indications and complications, practical pitfalls and techniques to enhance biopsy efficiency, diagnostic yield and cosmetic outcome. Our educational videos were launched initially at a large teaching hospital in the UK and watched by 25 dermatology trainees, with plans for upcoming open-access via our education website. The effectiveness of our learning material was evaluated through a preintervention survey of trainees to gauge prior exposure to dermatology surgery, followed by a postintervention survey. We found evidence of a lack of exposure to procedural dermatology among trainees in the preintervention survey, with improvements in trainee confidence reported following the educational videos. Delivering procedural videos through an accessible online resource is beneficial for dermatology trainees and allied healthcare professionals performing biopsies and diversifies the modality of procedural dermatology education. An online video format provides self-directed education that has flexibility and enables repeated access to reinforce learning, which complements and enhances in-person practical teaching.

Repair of a Nasal Tip Defect.

*All authors are affiliated with the Division of Dermatology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York Address correspondence and reprint requests to: David H. Ciocon, MD, Mohs Micrographic Surgery and Procedural Dermatology at the Montefiore Medical Center, Albert Einstein College of Medicine, 3411 Wayne Avenue 2nd Floor, Bronx, NY 10467, or e-mail: [email protected] The authors have indicated no significant interest with commercial supporters.

Procedural dermatology evaluation for residents: A system in progress.

Procedural dermatology evaluation for residents: A system in progress.

Procedural dermatology and its unmet need.

Procedural dermatology includes invasive conventional dermatologic surgeries which involve significant use of knife and suture, minimally invasive procedures and device-based procedures. Device-based procedures are the easiest to learn and are less prone to human errors due to automation but can lead to monotony, while conventional surgeries require significant skill, craftsmanship and interest. There has been a recent shift in the approach to procedural dermatology as a therapeutic option with complementary and combination models replacing the conventional hierarchical model in which procedures were last in the step-ladder approach. The demand for both conventional dermatologic surgeries and minimally invasive cosmetic procedures is increasing. Unfortunately, this demand has not been met with adequate supply. Consequently, the number of trained professionals with expertise in these procedures is very limited; they are far outnumbered by unqualified practitioners. A limited number of dermatologic surgeons practicing conventional surgeries has resulted in huge waiting lists for vitiligo surgeries, inappropriate excisions for skin cancers and poor cosmetic outcomes of excisions without proper knowledge of flaps and grafts. Increasingly procedures are being performed by inadequately trained personnel, resulting in complications. There is also an absence of good quality research on the subject of procedural dermatology, which has resulted in a lack of standardisation of various procedures and knowledge about the efficacy of various drug-procedure and procedure-procedure combinations. An increasing variety of gimmicky but costly procedures are being offered to the public without much evidence of efficacy. Individual institutional and broad policy directives are needed to address these issues. Special emphasis is required on formal hands-on procedural dermatology training during residency and beyond it.

34857 Trends in dermatology programs and positions from 2016-2020

The number of dermatology programs and positions is not fixed. A previous article published in the Journal of the American Academy of Dermatology (JAAD) looked at trends in dermatology residency and fellowship positions from 2005 to 2016. They reported an increase in the number of dermatology positions, an increase in the number of procedural dermatology, and a decrease in the number of dermatopathology positions. No updated articles have been published since then. This paper is an update of the literature and provides data on dermatology trends from 2016 to 2020. We used the ACGME data on dermatology residency and fellowship for program and position numbers and to calculate the changes. We used the census bureau for national population estimates to make population adjustments. When adjusted for population, there was a 13.4% increase in GME positions, a 17.4% increase in dermatology residency positions, a 12.3% decrease in the dermatopathology fellowship positions, and a 17.4% increase in procedural dermatology fellowship positions. Interestingly, the number of procedural dermatology positions has increased and the number of dermatopathology positions has decreased, which is consistent with the previous trends. The exact reasons for these trends are unknown and more research is warranted. Fortunately, the increase in positions is beneficial because there is a growing need for dermatologists, and research shows this problem is improving and will likely continue to do so if the trends continue in the coming years.

Timeline: The Evolution of Fellowship Training in Micrographic Surgery and Dermatologic Oncology.

The Accreditation Council for Graduate Medical Education (ACGME) granted accreditation to the first 5 Procedural Dermatology Fellowship Training Programs in 2004. The name of the training program was changed from Procedural Dermatology to Micrographic Surgery and Dermatologic Oncology by the ACGME/Residency Review Committee for Dermatology in 2014. The American Board of Dermatology/American Board of Medical Specialties conducted the first certification examination in Micrographic Dermatology Surgery in October 2021. This article chronicles the history and development of the subspecialty. J Drugs Dermatol. 2022;21(8):861-863.: doi:10.36849/JDD.6933.

Changing face of dermatology – A paradigm shift

Over the last three and half-decade of my life, I have seen the changes in dermatology and marked paradigm shift towards procedural dermatology and cosmetic dermatology. Dermatosurgery clinics started in 1996, and lasers were procured in 2009, setting the tone for laser and cosmetic dermatology at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. Cosmetic dermatology (aesthetic medicine/medical aesthetics) has now been recognized as a sub-specialty of dermatology. Dermatologists have supremacy over other aesthetic practitioners as they also treat visible as well as stigmatizing skin disorders. In the last two decades in India, more and more women are taking up dermatology to pursue aesthetic practice. Women in dermatology have started their association, the Women’s Dermatologic Society, and their journal, International Journal of Women’s Dermatology (IJWD). Skin lightening products are overwhelmingly used by women and are one of the world’s largest markets. Nowadays, aesthetic surgical procedures are done with a motive to earn profits. Cosmetology has gained tremendous interest in the world, especially in the United States of America. Much of its recognition is due to scientific research in the development of imaging techniques, drug therapy, and other nonsurgical methods lessening downtime for the patients. The focus in dermatology is shifting gradually from diseased skin to desired skin which people prefer. Hence, the journal CosmoDerma, gives cosmetology its due place. Moreover, there is an increase in the anti-ageing population in this world who don’t want their face wrinkles and aging skin changes. In the absence of world wars in recent times and the increasing longevity of man, the cosmetic industry/aesthetic industry is surging ahead despite the COVID 19 pandemic. Accreditation system to regulate the practice of cosmetology practice needed to be put in place in all countries. Many of these cosmetology practitioners are inadequately equipped to perform cosmetology procedures. There is a need for structured training and accreditation for cosmetic dermatology, aesthetic surgery, dermatosurgery, use of lasers, and hair transplantation.

National trends in gender and ethnicity in dermatology training: 2006 to 2018

To the Editor: Sex and race concordance between physicians and patients is associated with improved perceptions of clinical care.1Street R.L. O'Malley K.J. Cooper L.A. Haidet P. Understanding concordance in patient-physician relationships: personal and ethnic dimensions of shared identity.Ann Fam Med. 2008; 6: 198-205Crossref PubMed Scopus (341) Google Scholar In 2017, 48.9% and 64.5% of dermatology attendings and residents, respectively, were female.2Bae G. Qiu M. Reese E. Nambudiri V. Huang S. Changes in sex and ethnic diversity in dermatology residents over multiple decades.JAMA Dermatol. 2016; 152: 92-94Crossref PubMed Scopus (41) Google Scholar Academic dermatology leadership positions are underrepresented in sex and ethnic diversity.3Jayakumar K.L. Lipoff J.B. Trends in the dermatology residency match from 2007 to 2018: implications for the dermatology workforce.J Am Acad Dermatol. 2019; 80: 788-790Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar,4McDonald T.C. Drake L.C. Replogle W.H. Graves M.L. Brooks J.T. Barriers to increasing diversity in orthopaedics: the residency program perspective.JB JS Open Access. 2020; 5: e0007PubMed Google Scholar We examined sex and ethnicity trends of dermatology residents and fellows compared to other medical and surgical trainees. Demographics of dermatology residents and fellows and other of medical/surgical trainees were obtained from the Accreditation Council for Graduate Medical Education annual census, 2006 to 2018. Underrepresented minority (URM) was defined as Black/African American, Hispanic, or Native American. A 2-sample z-test was used to compare sex and ethnicity proportions in 2006 and 2018 (α level, <.05). Female representation in dermatology residency was stable at approximately 60% (Supplemental Table I; available via Mendeley at https://doi.org/10.17632/m3hs3dyr2n.1), and the overall residency census national average increased from 44% to 46% (P < .01) during the study period. Proportions of women in procedural dermatology and dermatopathology increased from 27% to 44% and from 46% to 54%, respectively (P > .05) (Fig 1). Female representation increased in all fellowship comparator groups; however, proportions of female fellows were consistently less than those of corresponding residencies in internal medicine, plastic surgery, and general surgery (Supplemental Table II; available via Mendeley at https://doi.org/10.17632/m3hs3dyr2n.1). All fields trended toward a narrowing of residency-fellowship gender gaps. Average URM representation in the overall residency national census increased from 12.5% in 2006 to 13.6% in 2018 (P < .05) (Supplemental Table I). URM representation in dermatology residency and fellowship increased from 8.2% to 9.3% and decreased from 9.5% to 3.1% (P > .05), respectively. URM representation in dermatology residency was consistently below the national average (Fig 2). URM residency-fellowship disparities persist in other fields (Supplemental Table II); however, only dermatology experienced a downward trend of URM fellowship representation over time. This study is limited by use of self-reported data and unknown rates of fellowship application by candidates of differing gender/ethnicity. We did not have access to pediatric dermatology fellowship data or total number of dermatology residency/fellowship positions. Our study showed significant narrowing of female residency-fellowship gaps and persistent URM dermatology residency underrepresentation and residency-fellowship gaps compared to the national average. Physician diversity is essential in addressing health care disparities.5Pritchett E.N. Pandya A.G. Ferguson N.N. Hu S. Ortega-Loayza A.G. Lim H.W. Diversity in dermatology: roadmap for improvement.J Am Acad Dermatol. 2018; 79: 337-341Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar Lack of URMs in leadership positions, mentorship, racism, and implicit bias have been cited as barriers for URMs pursuing subspecialties. Female and URM residents should be encouraged to seek mentorship from leaders of concordant and discordant gender and ethnicity. Mentorship programs, through the American Academy of Dermatology and Women's Dermatologic Society, which support URM medical students interested in pursuing dermatology and female resident dermatologists pursuing subspecialties, likely contributed to some of the upward trends observed. The Perry and student to resident institutional vehicle for excellence initiatives, Nth Dimension programs, and near-peer mentors have been successful in encouraging URMs to apply for competitive fields, subspecialties, and academic faculty positions. Similar initiatives should be adopted for dermatology. Early exposure of URMs to dermatology, updated curricula including skin of color topics, and rethinking residency selection criteria are also essential.5Pritchett E.N. Pandya A.G. Ferguson N.N. Hu S. Ortega-Loayza A.G. Lim H.W. Diversity in dermatology: roadmap for improvement.J Am Acad Dermatol. 2018; 79: 337-341Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar Our study highlights positive trends for women in dermatology residency/fellowships and significant deficiencies in URM representation in dermatology residency/fellowships. Increased efforts are needed to understand barriers to pursuing subspecialties and initiatives taken to promote mentorship and guidance to underrepresented groups. None disclosed.

Procedural Dermatology during COVID-19 Pandemic.

The Corona virus disease of 2019 (COVID-19) pandemic has imposed unprecedented challenges on the healthcare system including the specialty of dermatology. Procedural dermatology being an integral part of the specialty has also been profoundly affected where all elective and cosmetic procedures are presently being deferred, giving priority only to urgent and inescapable dermatologic procedures to curb down the risk of SARS-CoV-2 transmission in hospitals. With no certainty as to when the pandemic is going to end, procedural dermatology will be resumed in times to come, which must be taken up with cautious precautions. Dermatosurgeons must formulate protocols, restructure their facilities, and implement stringent measures with the aim to limit the spread of SARS-CoV-2, providing, at the same time, essential surgical care to patients. This review highlights the salient precautions to be observed in a dermatosurgery facility based on the current recommendations. The situation, however, remains fluid and as the pandemic is evolving, dermatosurgeons should remain vigilant and acquaint themselves with the latest guidelines.

Changing the Gear of Dermatology Practice During and after COVID-19 Pandemic

COVID-19 since the dawn has changed the way we look at things around us. Medical practice has changed drastically, so is dermatology practice. Clinical and procedural dermatology practice had come to a standstill in India, due to the past COVID-19 situations. With the changing scenario, now it is time for dermatologists as well as dermatology field to sail through these difficult times, with extra care and precautions. According to the latest CDC and ICMR guidelines, we have designed the following proposed guidelines from entrance to exit for the smooth functioning of dermatology institute/hospital/clinic. Potential setbacks related to patient and manpower, their management during COVID-19 pandemic has been reviewed. Potential setbacks related to clinical dermatology practice and procedures, their management during COVID-19 pandemic has been reviewed and briefed. Hard times are usually blessings in disguise; hence, we should utilize this pandemic period to learn and rejuvenate our practice.

Pediatric procedural dermatology.

Pediatric procedural dermatology is a broad and emerging field. Pediatric patients often present with unique diagnoses, and procedures in this population often require special tools. In addition, performing procedures on infants, children, and teenagers requires special considerations, skill sets, and knowledge. This article provides a brief overview of decision-making processes, common diagnoses, and common procedures performed by dermatologists in this patient population.

The aftermath of COVID-19 in dermatology practice: What's next?

The rapidly increasing number of COVID‐19‐infected patients and evidence of human‐to‐human transmission even within the asymptomatic incubation period prompted the attention of the entire world. The field of dermatology and procedural dermatology is not exempt from this global issue. We cannot deny the fact that this situation will have a lasting impact on the health‐seeking behaviors of our patients. It is necessary for dermatologists and dermatologic surgeons to be aware of the potential risks and precautions when re‐emerging their practices after COVID‐19.

Educational video improves dermatology residents' understanding of Mohs micrographic surgery: A survey-based matched cohort study

To the Editor: Dermatology resident experience with Mohs micrographic surgery is highly variable,1Lee E.H. Nehal K.S. Dusza S.W. Hale E.K. Levine V.J. Procedural dermatology training during dermatology residency: a survey of third-year dermatology residents.J Am Acad Dermatol. 2011; 64: 475-483Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar,2Reichel J.L. Peirson R.P. Berg D. Teaching and evaluation of surgical skills in dermatology: results of a survey.Arch Dermatol. 2004; 140: 1365-1369Crossref PubMed Scopus (37) Google Scholar and it has been reported that surgical training is often underemphasized in the course of dermatology training compared with other proceduralists.3Alam M. Dermatologic surgery training during residency: room for improvement.Dermatol Surg. 2001; 27: 508-509PubMed Google Scholar In surgery, especially dermatologic surgery, there is a need to quickly and intuitively transmit complex information to a wide physician audience, and various creative methods have been attempted, including YouTube4Koya K.D. Bhatia K.R. Hsu J.T. Bhatia A.C. YouTube and the expanding role of videos in dermatologic surgery education.Semin Cutan Med Surg. 2012; 31: 163-167Crossref PubMed Scopus (27) Google Scholar and metaphor.5Lee E. Wolverton J.E. SomaniAK A simple, effective analogy to elucidate the Mohs micrographic surgery procedure – the peanut butter cup.JAMA Dermatol. 2017; 153: 743-744Crossref PubMed Scopus (6) Google Scholar We created a mixed live-action and animated video demonstrating an introduction to Mohs micrographic surgery in an effort to improve residents' basic understanding of how, why, and when Mohs micrographic surgery is performed, with additional information on special considerations for Mohs micrographic surgery performed on unique anatomic locations. Although it was never intended to replace any part of a formal Mohs micrographic surgery fellowship, we hoped that residents' confidence with the basic concepts of Mohs micrographic surgery would improve with this approachable educational method. In this survey-based, matched-cohort study, 83 dermatology resident physicians were recruited by contacting Accreditation Council for Graduate Medical Education program coordinators and requesting dispersal within their programs through the Association of Professors of Dermatology LISTSERV (L-Soft International, Bethesda, MD). The residents were asked to complete a preliminary survey to self-rate their comfort level of Mohs micrographic surgery. The survey consisted of 5 basic Mohs competencies, and participants were asked to rate their comfort with each competency as 1 (low) through 5 (high). They were then asked to view 2 short, educational video modules on Mohs micrographic surgery. The first video demonstrates the excision of a sample and its histologic preparation—and how uniquely in Mohs micrographic surgery this allows for evaluation of complete margins with accurate reference to surrounding surface anatomy. The second video demonstrates special anatomic considerations for excising and preparing samples taken from the eyelids, lips, and nails. After viewing the 2 modules, residents reanswered the same survey questions (Fig 1). The combination of premodule and postmodule answers were presented in a cross-tabulation table for each of the 5 questions. Values above the descending diagonal represented higher responses on the postsurvey, and values below this diagonal indicated higher responses on the presurvey. Owing to non-normal distributions for the survey questions, a nonparametric Wilcoxon signed rank test was used to compare the paired responses. This analysis was performed using SAS 9.4 software (SAS Institute Inc, Cary, NC), and a P value of <.05 was considered statistically significant. Our results demonstrated that the video modules significantly improved residents' self-rated comfort in all survey questions (P < .05) (Fig 2). After viewing the video modules, residents assessed themselves as more comfortable with how the layer is taken by the surgeon, how the layer is inked by the surgeon, how the tissue is positioned on the slide, how 100% of the margin is cleared by the surgeon, and unique issues for specific anatomic locations. With wide variation in Mohs micrographic surgery experience among dermatology residents, an approachable medium for resident exposure to Mohs micrographic surgery is needed, and a module conveying 3-dimensional content may fill that need. Our Mohs micrographic surgery video modules improved residents' self-rated confidence with the basics of Mohs micrographic surgery.

2020: Laser-Focused on Procedural Pediatric Dermatology.

2020: Laser-Focused on Procedural Pediatric Dermatology.

Recommendations for Cutaneous and Aesthetic Surgeries during COVID-19 Pandemic.

Background:Amid the coronavirus disease 2019 (COVID-19) pandemic, dermatologists must be prepared to restructure their practice of procedural dermatology and cutaneous aesthetic surgeries. The COVID-19 pandemic has presented several challenges and has ushered in several changes in practice such as teledermatology, with many physicians adopting virtual consultations and treatments. Performing procedures in the times of COVID-19 pandemic presents challenges such as risk of transmission to doctors and staff due to potential aerosolization, release of virus droplets during the procedures, and risk of virus transfer through the instruments both in the peri- and postoperative period. This can have several medical, administrative, and legal implications.Objectives:This document aimed to outline best practices that can be followed in this scenario to perform cutaneous surgeries and procedures to ensure safer skin surgery.Recommendations:Standard precautions include social distancing of at least 1 m, hand hygiene, appropriate use of personal protective equipment (PPE), safe injection practices, sterilization and disinfection of medical devices, environmental cleaning, and respiratory hygiene. It is generally advisable to see patients only by appointments. Each clinic should have a special area at entry for screening patients and providing sanitizers and masks. Procedures, which are of short duration, performed on nonfacial areas are considered as low risk and require donning surgical mask. Procedures involved with minimal invasiveness and bleeding, short duration procedures on the face such as injectables, chemical peels, and aerosol-generating procedures on nonfacial areas are considered moderate risk. These procedures need apron with head cover, N95 mask, face shield, double gloves, and smoke evacuator with high-efficiency particulate air (HEPA) or ultralow particulate air (ULPA) filter. Aerosol and plume-regenerating procedures (such as ablative lasers on the face), prolonged surgeries on head (such as hair transplantation), intraoral, and intranasal procedures are considered high risk. These procedures must be carried out with full body cover with surgical gown, head cover, N95 mask, face shield, double gloves, and smoke evacuator. Physicians should be aware of local epidemiological situation and adhere to the relevant guidelines issued by the relevant governmental agencies.

The Physician's Guide to Platelet-Rich Plasma in Dermatologic Surgery Part II: Clinical Evidence.

Platelet-rich plasma (PRP) is an increasingly popular treatment modality for various dermatologic conditions, but there are limitations in both the published literature and clinician knowledge. To create a high-yield, in-depth analysis of PRP in procedural dermatology by reviewing available data on its role in hair restoration, soft-tissue remodeling, resurfacing, and rejuvenation; identifying practice gaps and controversies; and making suggestions for future research that will establish dermatologists as pioneers of regenerative medicine. A two-part systematic review and expert analysis of publications before October 2018. Most studies on PRP report favorable outcomes with the strongest level of evidence existing for androgenetic alopecia followed by postprocedure wound healing, scar revision, striae, rejuvenation, and dermal filling. There is a dearth of large randomized controlled trials, considerable heterogeneity in the variables studied, and lack of specificity in the preparatory protocols, which may influence clinical outcomes. Future investigations should use consistent nomenclature, find ideal solution parameters for each cutaneous indication, determine significant outcome metrics, and follow double-blinded, randomized, controlled methodologies. Addressing these deficiencies will take sound scientific inquiry but ultimately has the potential to benefit the authors' specialty greatly.

The Physician's Guide to Platelet-Rich Plasma in Dermatologic Surgery Part I: Definitions, Mechanisms of Action, and Technical Specifications.

Platelet-rich plasma (PRP) is an increasingly popular treatment modality for various dermatologic conditions, but there are limitations in both the published literature and clinician knowledge. To create a high-yield, in-depth analysis of PRP in procedural dermatology by reviewing available data on its role in hair restoration, soft-tissue remodeling, resurfacing, and rejuvenation; identifying practice gaps and controversies; and making suggestions for future research that will establish dermatologists as pioneers of regenerative medicine. A 2-part systematic review and expert analysis of publications before October 2018. Most studies on PRP report favorable outcomes with the strongest level of evidence existing for androgenetic alopecia followed by postprocedure wound healing, scar revision, striae, rejuvenation, and dermal filling. There is a dearth of large randomized controlled trials, considerable heterogeneity in the variables studied, and lack of specificity in the preparatory protocols, which may influence clinical outcomes. Future investigations should use consistent nomenclature, find ideal solution parameters for each cutaneous indication, determine significant outcome metrics, and follow double-blinded, randomized, controlled methodologies. Addressing these deficiencies will take sound scientific inquiry but ultimately has the potential to benefit the authors' specialty greatly.